A survey of the property, with a drawing showing where the fence will be located, and showing the linear footage for each area of fence must be attached to this document and submitted at the same time as this Fence Permit Application.

Tax ID #:

Permit No.:

Application Date:*

Entered by:

Job Name:*

Street Number and Name:*

City/State/Zip:*

Phone:*

Email:

Owner Information

Title Holder:*

Street Number and Name:*

City/State/Zip:*

Phone:*

Email:

Contractor Information

Contractor's Name:

Qualifier's Name:

License No.:

Street Number and Name:

City/State/Zip:

Phone:

Fax:

Permit Information

Permit Type:*

Residential

Commercial

Description of Work:*

Value of Construction:*

Total Linear Feet:*

Survey showing location and linear footage of each area of fence*

Applicant's Affidavits

Application is hereby made to obtain a permit to do the work and installation as indicated. The Building Code in effect at the time of this application is the Florida Building Code 2007 Edition. I understand that all permits require inspections as indicated. This permit application is valid for 180 days from the date of submission.

I certify

that no work or installation has commenced prior to the issuance of a permit*

I understand

that the fence which I have applied for a permit to construct would be located upon the public easement, utility easement or a public right-of-way.*

I understand

and hereby agree that, as a condition of the permit, should the fence require removal or should any damage to the fence occur as a result of its location in such right-of-way or easement, installation or repair shall be at my expense and not at the expense of the City of West Melbourne or any public utility. This agreement will be passed on to my successor in interest in the property described in this application for Fence Permit.*

WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.

____________________________________Owner's/Agent's Signature

State of FloridaCounty of BrevardThe foregoing instrument was acknowledgedBefore me this ___ day of __________20__

By __________________________ who isPersonally known to me, or has produced

_____________________________________as identification and who did not take an oath

____________________________________Notary as to Owner or AgentSeal

____________________________________Contractor's Signature

State of FloridaCounty of BrevardThe foregoing instrument was acknowledgedBefore me this ___ day of __________20__

By __________________________ who isPersonally known to me, or has produced

_____________________________________as identification and who did not take an oath